Innovation is the latest buzzword in the NHS. When the health secretary, Andrew Lansley, addressed delegates at the NHS confederation last week he stressed the importance of changing services in unique ways in order to meet efficiency saving targets under the new reforms.

"We have to go beyond the short-term savings and on to innovation which will deliver in the long term," Lansley said. "This is not just innovation in products and drugs. This is about service innovation – it is fundamentally about continuously redesigning the service that we provide."

He echoed almost word for word the confederation's chief executive, Mike Farrar, who in his opening address at the conference urged local leaders in the NHS to "be brave" when looking at new ways to drive change.

They were both, however, also talking about a national organisation that caters for a population of 52 million, employs more than 1.7 million people, and where a centralised electronic patient records system seems a long way into the future. How much room is there for real innovation in the NHS, which, according to Farrar, "reinvents the wheel, and changes habits of the past"? And can such a large publicly-funded organisation take risks to drive innovation without the fear of experiencing the wrath of the readers of local papers and the national press?

As one communications manager from a large NHS organisation pointed out: "There's a fear that 'innovation' in the NHS is just going to generate bad headlines in papers that don't understand the financial pressures the NHS is under."

David Stout, deputy chief executive of the NHS confederation, agreed that sometimes work in the NHS can be interpreted differently in the press than within the healthcare sector: "Telehealth practically means less hospital beds because the care is taking place in the community and at home, but the fewer beds aspect is more likely to be picked up on in the press, instead of the new technology which is helping people with their healthcare."

Though this was an extreme case with other contributing factors, the tension between a move to more specialised services across the country and headlines of "postcode lotteries" is a recurring one in the NHS. Debbie Garritty, director of communications at Manchester mental health and social care NHS trust explained: "People have a fear of things that affect change in the NHS – it impacts so many of people's lives. There is an emotional ownership of the NHS which forms part of a certain accountability."

Anne-Marie Miller, who is now communications manager at Salford Royal NHS, said that after the decision was made to transfer maternity and neonatal services to other local hospital sites, it was the job of the communications team "to maintain a very factual, yet compassionate tone in response to any further media".

For journalist SA Mathieson, though, the importance in communicating issues like localised specialised services is "creating a narrative". He gave the example of the treatment that Fabrice Muamba received following a cardiac arrest during a football match earlier this year.

The Bolton Wanderers star was taken to the specialist London chest hospital in Bethnal Green, almost eight miles away from where the incident happened, rather than the North Middlesex, which is much nearer White Hart Lane. This decision was thought to have saved the footballer's life. Sanjay Sharma, a cardiology specialist at St George's University hospital, explained: "It was vital. Bethnal Green has equipment which can make a great difference. Ambulances don't have them, and the other hospital wouldn't have."

Miller, who is part of a communications team that Mathieson hails as one with excellent media relations, said that "getting back to basics" when communicating reconfiguration changes and new processes in the NHS is key.

"We have press planning meetings where we look at how we have done, what areas we can improve on and what's the story for the next few weeks," he said. "We have invited some of our local journalists in to meet with us for a coffee to show our setup and explain our wide remit, which has really helped to establish and develop our working relationship.

"Twitter is also a quick and effective way to build relationships with journalists. Last week we tweeted a picture over to a reporter and it got published in the next edition. We probably wouldn't have invested resource to even write about the release or event, but it was picked up and it took two minutes for us."

Miller said that good internal communication at the hospital is also important. "We are setting up internal online systems that help our staff to get their news out there, which is in line with our overall approach to internal communications: providing tools to empower staff to communicate with the public."